Chen Ruoling, Wei Li, Hu Zhi, Qin Xia, Copeland John R M, Hemingway Harry
Department of Epidemiology and Public Health, Royal Free and University College Medical School, University College London, England.
Arch Intern Med. 2005 Sep 26;165(17):2019-25. doi: 10.1001/archinte.165.17.2019.
In Western countries depression is the most common psychiatric condition in older persons and related to low socioeconomic status and low social supports. Along with social deprivation, the rural communities in China retain many Chinese traditions that involve high levels of social supports. Studying such a population might offer insights into the cause and prevention of depression that may be applicable in developing and developed countries.
Using a cross-sectional, household-based, community survey in rural China, we aimed to determine the prevalence of and risk factors for depression among older people who had a low income (mean annual per capita income of about 280 US dollars) and high social support in 16 villages in Anhui Province. Participants included 754 men and 846 women aged 60 years or older. Depression was diagnosed using the Geriatric Mental State and the Automated Geriatric Examination for Computer Assisted Taxonomy. Risk factors, collected from the standard questionnaire and physical measurements, were examined in a stepwise multiple logistic regression model.
The prevalence of depression (world age standardized) was 6.0% (95% confidence interval [CI], 4.8%-7.3%). Of all persons, 1374 older persons (85.9%) living with family members. Depression was significantly and independently associated with female gender, low family income, lack of social support, relationship problems, poor health status, and adverse life events in the past 2 years. The risk of depression increased in those eating meat less than once a week (multiple-adjusted odds ratio, 2.20; 95% CI, 1.20-4.03), not watching television (odds ratio, 1.76; 95% confidence interval, 1.03-3.00), and having undetected hypertension (odds ratio, 1.78; 95% CI, 1.05-3.01).
Older people in rural China have a lower risk of depression than those in Western countries. Low socioeconomic status showed a "dose-response" relationship with depression, and social supports were much more common, which were protective for depression. Further exploration of Chinese culture and tradition may yield universal insights into preventive factors for depression in older people.
在西方国家，抑郁症是老年人中最常见的精神疾病，与社会经济地位低下和社会支持不足有关。除了社会剥夺之外，中国农村社区保留了许多包含高水平社会支持的传统中国习俗。研究这样的人群可能会为抑郁症的病因和预防提供见解，这些见解可能适用于发展中国家和发达国家。
我们在中国农村进行了一项基于家庭的横断面社区调查，旨在确定安徽省16个村庄中低收入（人均年收入约280美元）且社会支持高的老年人中抑郁症的患病率和危险因素。参与者包括754名男性和846名60岁及以上的女性。使用老年精神状态和计算机辅助分类的自动老年检查来诊断抑郁症。从标准问卷和体格测量中收集的危险因素在逐步多元逻辑回归模型中进行检验。
抑郁症的患病率（世界年龄标准化）为6.0%（95%置信区间[CI]，4.8%-7.3%）。在所有参与者中，1374名老年人（85.9%）与家庭成员同住。抑郁症与女性性别、家庭收入低、缺乏社会支持、关系问题、健康状况差以及过去两年中的不良生活事件显著且独立相关。每周吃肉少于一次的人患抑郁症的风险增加（多元调整优势比，2.20；95%CI，1.20-4.03），不看电视的人（优势比，1.76；95%置信区间，1.03-3.），以及患有未被发现的高血压的人（优势比，1.78；95%CI，1.05-3.01）。
中国农村老年人患抑郁症的风险低于西方国家的老年人。社会经济地位低下与抑郁症呈“剂量反应”关系，社会支持更为普遍，对抑郁症具有保护作用。对中国文化和传统的进一步探索可能会为老年人抑郁症的预防因素提供普遍的见解。
